Dr. Scott Gottlieb says the Covid delta surge may be the ‘final wave’ in U.S.

Dr. Scott Gottlieb told CNBC on Monday the current surge in Covid infections caused by the more contagious delta variant may be the “final wave” of the virus in the United States.

“I don’t think Covid is going to be epidemic all through the fall and the winter. I think that this is the final wave, the final act, assuming we don’t have a variant emerge that pierces the immunity offered by prior infection or vaccination,” the former Food and Drug Administration commissioner said on “Squawk Box.” “This is probably going to be the wave of infection that ends up affecting the people who refuse to get vaccinated.”

Gottlieb said Americans have a couple months remaining where they need to take pandemic-related precautions, particularly in northern U.S. states as cases begin to peak in the South, until the wave of infections begins to decrease again.

“I think this is going to be a difficult period right now,” he said. However, Gottlieb said the contagious nature of the delta variant and increased vaccination rates could change the trajectory of future infections.

“We’re going to reach some level of populationwide exposure to this virus, either through vaccination or through prior infection that’s going to stop circulating at this level, at this rate,” said Gottlieb, who led the FDA from 2017 to 2019 under the Donald Trump administration.

The seven-day average of new daily coronavirus cases in the U.S. is 108,624, according to a CNBC analysis of Johns Hopkins University data. That’s up 36% compared with one week ago. The highly transmissible delta variant, first identified in India, is estimated to comprise 83% of all sequenced Covid cases in the country, according to Centers for Disease Control and Prevention estimates.

With the surge in infections coinciding with school reopening plans in the fall, Gottlieb warned that schools may need to begin the year with heavier mitigation measures in place like mask-wearing, testing, physical distancing and gathering through pods. 

“The goal has to be to get schools open and keep them open, and we can’t expect to change all the behaviors in terms of what we’re doing with respect to mitigation in schools and get the same result, especially with this new delta variant which is more contagious, and is inevitably going to be hard to control in the schools,” said Gottlieb, who serves on the board of Covid vaccine maker Pfizer.

Large amounts of vaccinated people can still gather in a venue if there is some “semblance of a bubble” around it, he said. Vaccinated people who are getting infected are likely contracting the virus from unvaccinated people, and then spreading it to close contacts after being contagious for a brief window of time, the former FDA chief said.

Gottlieb said wearing a higher-quality mask, like the KN95 mask, is more important now as the virus is known to spread through aerosols and not droplets. A high-quality cloth mask affords only 20% protection from transmission, and most people don’t wear them well, he said.

“We are taking sort of an alpha mindset into a delta world, and it’s not going to work,” Gottlieb said, referring to the alpha coronavirus variant first detected in the U.K. last year. “We’re going to see that this delta variant is more difficult to control,” he said.

Disclosure: Scott Gottlieb is a CNBC contributor and is a member of the boards of Pfizer, genetic testing start-up Tempus, health-care tech company Aetion and biotech company Illumina. He also serves as co-chair of Norwegian Cruise Line Holdings’ and Royal Caribbean’s “Healthy Sail Panel.”